Effect modification by chronic obstructive pulmonary disease, anion gap, and serum creatinine on the association between invasive mechanical ventilation and 28-day mortality in intensive care unit sepsis patients: a retrospective cohort study - Summary - MDSpire
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Effect modification by chronic obstructive pulmonary disease, anion gap, and serum creatinine on the association between invasive mechanical ventilation and 28-day mortality in intensive care unit sepsis patients: a retrospective cohort study
To evaluate the association between mechanical ventilation (MV) and 28-day mortality in ICU sepsis patients and to explore potential effect modifiers, such as chronic obstructive pulmonary disease (COPD), anion gap, and serum creatinine.
Key Findings:
75.3% of patients received mechanical ventilation.
28-day mortality was higher in the MV group (56.0%) compared to the non-ventilation group (29.5%, p < 0.001).
MV was independently associated with increased 28-day mortality (adjusted OR 2.62, 95% CI 1.67–4.11, p < 0.001).
Chronic obstructive pulmonary disease (COPD), anion gap, and serum creatinine significantly modified the MV-mortality association.
Interpretation:
The adverse association of MV with mortality was more pronounced in patients with elevated anion gap, lower serum creatinine, and those without COPD, indicating the need for tailored management strategies.
Limitations:
Retrospective design may introduce bias.
Single-center study limits generalizability.
Potential confounding factors not fully accounted for.
Biases inherent in retrospective studies may affect results.
Conclusion:
Mechanical ventilation is associated with increased 28-day mortality in ICU sepsis patients, particularly influenced by specific clinical and laboratory parameters.
Older age, male sex, underweight status, reduced activities of daily living, and mild consciousness disturbance were associated with postextubation pneumonia in elective surgical patients.
